Name of the Procedure:

Tenotomy, open, tendon flexor; foot, single or multiple tendon(s) (separate procedure)

Summary

An open tenotomy is a surgical procedure performed to release tight flexor tendons in the foot. It involves making an incision to access and cut the tendon(s), providing relief from issues caused by constricted tendons.

Purpose

This procedure addresses conditions involving tight or shortened flexor tendons in the foot, such as hammertoes or claw toes. The goal is to improve foot function, alleviate pain, and enhance mobility.

Indications

• Symptoms of restricted tendon movement or deformity in the foot
• Pain and discomfort due to overly tight flexor tendons
• Failure of conservative treatments such as physical therapy or orthotics

Preparation

• Patients may be instructed to fast for several hours prior to the procedure.
• Adjustments to current medications may be necessary.
• Pre-operative assessments might include physical exams, imaging studies like X-rays, and blood tests.

Procedure Description

1. Anesthesia: The procedure is typically done under local or general anesthesia.
2. Incision: A small incision is made over the affected area of the foot.
3. Tendon Access: The surgeon carefully separates surrounding tissues to expose the tight flexor tendon(s).
4. Tendon Release: The surgeon cuts the tendon(s) to release the tension and correct deformity.
5. Closure: The incision is closed with sutures or staples, and a sterile dressing is applied. Tools: Scalpels, retractors, surgical scissors, and suturing materials.

Duration

The procedure usually takes about 30 minutes to 1 hour, depending on the number of tendons involved.

Setting

This surgery is typically performed in a hospital or an outpatient surgical center.

Personnel

• Orthopedic Surgeon or Podiatric Surgeon
• Anesthesiologist or Nurse Anesthetist
• Surgical Nurse(s)
• Operating Room Technician

Risks and Complications

• Infections at the incision site
• Bleeding or blood clots
• Nerve damage leading to numbness or tingling
• Recurrence of tendon tightness
• Poor wound healing or scarring

Benefits

• Relief from pain and discomfort
• Improved foot alignment and function
• Enhanced mobility and ability to partake in daily activities These benefits might be realized within a few weeks after surgery, following an appropriate recovery period.

Recovery

• Patients need to keep the foot elevated and avoid putting weight on it initially.
• Pain management may include prescribed medications.
• The recovery period usually spans a few weeks, during which physical therapy may be recommended.
• Follow-up appointments are necessary to monitor healing and adjust postoperative care.

Alternatives

• Physical therapy and stretching exercises: Effective for mild cases but may not suffice for severe tendon tightness.
• Orthotic devices: Provide support but do not address the root cause.
• Minimally invasive procedures: Might be considered, though they may not be suitable for all patients.

Patient Experience

Patients may feel discomfort or mild pain during the initial recovery phase, which is managed through medication and rest. Swelling and bruising around the surgical site are common. Gradual improvement in foot function and reduction in symptoms are expected as healing progresses.